Department File Number : | M201573526 |
Claim Number : | 2107-P |
Date Submitted : | 2/19/2015 |
Insurer Information | |||||
Insurer Name | Coverage Type | ||||
NATIONAL MEDICAL PROFESSIONAL RISK RETENTION GROUP, INC. | Primary | ||||
Insurer FEIN | Professional License Number | ||||
20-3516222 | |||||
Insurer Contact Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Denyse | A | Austra | ||
Street Address | |||||
2270 Colonial Blvd | |||||
City | State | Zip | |||
Ft. Myers | FL | 33907 | |||
Phone | Ext | Fax | E-Mail Address | ||
(239) 931 - 7303 | Denyse.Austra@21co.com |
Insured Information | |||||
Type | First Name | MI | Last Name | ||
Individual | Antonio | Reyes | |||
Insurer Type | Street Address of Practice | ||||
Licensed | 2261 N University Drive, Suite 202 | ||||
City | State | Zip Code | County | ||
Pembroke Pines | FL | 33024 | Broward | ||
Policy Number | Per Claim Policy Limits | Aggregate Policy Limits | |||
NMP-FL860013 | $250,000 | $750,000 | |||
Profession or Business | Other Profession or Business | ||||
Medical Doctor | |||||
License Number | Specialty Code & Classification | Certification Number | |||
ME70206 | Surgery - Urological |
Injured Person Information | |||||
First Name | MI | Last Name | Date of Birth | ||
Street Address | Gender | County where Injury Occurred | |||
M | Broward | ||||
City | State | Zip Code | |||
Location where injury occured | Other location where injury occured | ||||
Physician's Office | |||||
Name of Institution | Code | ||||
Location of Institutional Injury | Other Location of Institutional Injury | ||||
Date of Occurrence | Date Reported to Insurer | ||||
4/6/2012 | 2/14/2014 |
Diagnostic Information | |||||
Final Diagnosis For Which Treatment Was Sought Including Patient's Actual Condition | |||||
Patient seen post treatment for renal cell carcinoma. Being followed with scans and x-rays. Lung x-ray showed 6 mm lung nodule; later CT showed 9 mm nodule. | |||||
Operation, Diagnostic, Or Treatment Procedure Rendered Causing The Injury | |||||
Alleged delayed diagnosis and treatment. | |||||
Diagnostic Code : | |||||
Misdiagnosis Made, If Any, Of Patient's Actual Condition | |||||
*NR | |||||
Principal Injury Giving Rise To The Claim | |||||
Metastasis attributed to alleged delay in diagnosis. | |||||
Severity Of Injury | |||||
Permanent: Death. |
Legal Information | |||||
Date of Suit | Circuit Court Case Number | ||||
8/28/2014 | 14-016845 (13 ) | ||||
County Suit Filed in | Date of Final Disposition | ||||
Broward | 10/13/2014 | ||||
Other Defendants Involved in this Claim | |||||
21st Century Oncology, Inc. | |||||
Stage of Legal System at which Settlement was Reached or Award Made | |||||
Within 90 days of suit being filed. | |||||
Final Method of Claim Disposition | |||||
Settled by parties | |||||
Court Decision | Other | ||||
No Court Proceedings. | |||||
Arbitration | |||||
Claim not subject to Arbitration. | |||||
Date of Payment | |||||
9/29/2014 |
Financial Information | |||||||||||||||||||||
Was there a settlement Resulting in payment to the Plaintiff? | Yes | ||||||||||||||||||||
Indemnity Paid by Insurer on behalf of Insured | $250,000 | ||||||||||||||||||||
Loss Adjust Expense Paid to Defense Counsel | $43,683 | ||||||||||||||||||||
All Other Loss Adjustment Expense Paid | $0 | ||||||||||||||||||||
Injured Person's Total Non-Economic Loss | $0 | ||||||||||||||||||||
Deductible | $0 | ||||||||||||||||||||
Injured Person's Total Economic Loss | |||||||||||||||||||||
| |||||||||||||||||||||
Safety Management Steps Taken by Insured to Make Similar Occurrence Less Likely | |||||||||||||||||||||
N/A |
Updates | |
No updates found. |
*NR: Prior to 04/28/1999 this field was not required in submitted claims. This page is not displaying certain sensitive information.
Does Dr. ANTONIO REYES, MD have any medical malpractice cases, lawsuits, or complaints?
Dr. ANTONIO REYES, MD has at least 1 medical malpractice case(s), lawsuit(s), or complaint(s).